Provider Demographics
NPI:1134875875
Name:DANIELS, DONELLA
Entity type:Individual
Prefix:
First Name:DONELLA
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 LOOP DR # 183
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1108
Mailing Address - Country:US
Mailing Address - Phone:216-290-8231
Mailing Address - Fax:
Practice Address - Street 1:2706 LOOP DR # 183
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1108
Practice Address - Country:US
Practice Address - Phone:216-290-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide